Multimodal Physical Therapy found Effective for Chronic Pelvic Pain, suggests research
Multimodal physical therapy was found to reduce pain intensity significantly in women with chronic pelvic pain (CPP), as reported by a recent study published in the American Journal of Obstetrics and Gynecology. Chronic pelvic pain is a complex condition affecting the quality of life in women, and its implications reach the domains of physical, psychological, and sexual health. The study was conducted by Małgorzata Starzec-Proserpio and colleagues.
The study used data from 38 randomized controlled trials involving 2168 women with a mean age of 35.1±8.6 years. The search for literature of electronic databases such as Medline, PubMed, Embase, and Cochrane Central Register of Controlled Trials was done in January 2023 and updated in December 2023. Randomized controlled trials were included for nonpharmacological conservative therapies against placebo, usual care, or other treatments that are not conservative in nature, such as surgical or pharmacological interventions.
Therapies considered were as follows:
Multimodal physical therapy
Psychological approaches
Acupuncture
Tissue-based monotherapies such as electrophysical agents, manual stretching.
The studies with similar intervention and outcome were analyzed using a random effect model to perform the meta-analysis. Outcomes assessed included pain intensity, sexual function, psychological health, and physical functions as well as quality of life. The Physiotherapy Evidence Database scale and GRADE criteria were used to review the evidence quality and certainty.
Results
Of 5776 studies retrieved, 38 randomized controlled trials were included in the analysis.
Multimodal Physical Therapy:
Short-term: Pain intensity significantly reduced (standardized mean difference [SMD] −1.69, 95% CI −2.54, −0.85; high certainty).
Intermediate-term: Pain intensity also reduced (SMD −1.82, 95% CI −3.13, −0.52; moderate certainty).
Predominantly Psychological Approaches:
No significant effect on pain intensity (SMD −0.18, 95% CI −0.56, 0.20; moderate certainty).
Slight improvement in sexual function (SMD −0.28, 95% CI −0.52, −0.04; moderate certainty).
Acupuncture:
Results showed no statistically significant effect on pain intensity (SMD 1.08, 95% CI −1.38, 3.54), favoring control treatment.
Multimodal physiotherapy represents an effective, evidence-based approach in decreasing intensity of pain in females with CPP. Its inclusion into clinical practice has become necessary in order to promote better patient results.
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